Women still underrepresented in clinical research, science and medicine that could save them from their No. 1 killer – Cardiology2.0

Cardiovascular disease is the No. 1 killer of women worldwide, yet women continue to be grossly underrepresented in heart disease and stroke research, in research publishing roles and even in the medical practice of cardiology, according to data published today inCirculation, the flagship journal of the American Heart Association.

For the fourth year in a row, the editors ofCirculationhave published a special February issue focusing on the unique challenges that women face in their fight against heart disease and stroke. This years issue launches the journals new Science Goes Red collection, a collaboration withGo Red for Women, the global movement to end heart disease and stroke in women from the American Heart Association.

This issue features more than a dozen manuscripts, including peer-reviewed full papers, research letters, clinical and professional perspectives, editorials and feature interviews.

One woman dies from cardiovascular disease every 80 seconds. Its the leading killer of all women around the globe, claiming the lives of one in every three women, yet disparities continue to persist when it comes to symptom recognition, treatment times and methodologies, and even lifesaving support measures, said Editor-in-Chief ofCirculationJoseph A. Hill, M.D., Ph.D., FAHA, chief of cardiology at the University of Texas Southwestern Medical Center in Dallas. We are pleased to highlight some of the best cardiovascular science focusing on women, and we maintain an ongoing commitment to move the field forward, working with investigators and clinicians around the world to eliminate disparities for women in health care and within the biomedical workforce.

Lack of knowledge is often cited as a reason for these disparities, as women have historically been underrepresented in cardiovascular research. This trend continues an analysis of cardiovascular research data found that women comprised less than 40% of all people enrolled in cardiovascular clinical trials between 2010-2017.

Researchers examined 740 completed cardiovascular clinical trials reported between January 1, 2010 and December 31, 2017 on ClinicalTrials.gov, one of the largest and longest running trial registries in the world, a resource provided by the U.S. National Library of Medicine and managed by the National Institutes of Health. Of the 862,652 adults in the trials, the average age of trial participants of both sexes was 60.8 years, ranging from 25 to 89 years.

Researchers found:

Study authors argued that several effective strategies are needed to include more women in cardiovascular research; however, until that happens, health care providers should be mindful of gender differences in disease diagnosis, manifestation treatment and prognosis.

The American Heart Associations Go Red for Women movement and Verilys ProjectBaseline have joined forces to launch Research Goes Red, an initiative calling on women across the United States to contribute to and participate in health research. Women can learn more and get involved atprojectbaseline.com/gored.

Publishing clinical research results in peer-reviewed scientific journals is an important capstone, yet a review in this issue ofCirculationfound that not only are women underrepresented in the research, theyre also underrepresented among the editorial boards of those journals.

Researchers set out to determine the current status of women on journal editorial boards by looking at the January 2018 mastheads of general cardiology journals from the U.S. (Circulation, Journal of the American College of Cardiology, Journal of the American Medical Association CardiologyandAmerican Journal of Cardiology) and the 2019 mastheads for general cardiology journals from Europe (Heart, International Journal of CardiologyandEuropean Heart Journal). They also reviewed information on more than a dozen subspecialty journals, including four fromCirculationCardiovascular Imaging, Cardiovascular Interventions, Heart FailureandArrhythmia and Electrophysiology. They compared trends over the past 20 years and found:

The authors said their study highlights the need for continued attention to barriers in career advancement for women in cardiology. Engagement of women faculty at early career stages as ad hoc reviewers would help create a robust pipeline of future women editors. Diversity in editorial boards can not only improve the societal relevance and quality of the journal, but also provides women role models for future generations. A more gender-balanced and diverse editorial team adds value by decreasing publication bias against women, providing a favorable impression of the journal and increasing likelihood of competitive submissions, they concluded in their review.

Gender disparities in heart disease and stroke arent limited to how they are studied, diagnosed or treated, they also exist when it comes to who is doing the research and providing the health care, according to a research letter in this special issue ofCirculation.

The 2017-2018 report of the Association of American Medical Colleges showed women made up less than a fourth (21.4%) of all adult cardiology trainees, only a modest increase from a decade ago (15.9%).

A review of the Accreditation Council for Graduate Medical Education-accredited training program data found that cardiology ranked second for the most underrepresented specialty of women (21%), preceded only by orthopedic surgery (15.3%), with obstetrics/gynecology having the highest representation of women trainees (83%).

The researchers said their finding show that marked gender disparity still prevails for training within the cardiology field and its subspecialties, with little change occurring over the past decade, highlighting the importance of appropriate measures to achieve higher gender equity and focused follow-up evaluations of effectiveness.

Other studies within this special issue ofCirculationevaluate the link between breast cancer and heart disease; the unique risk factors women face that make a one-size-fits-all heart disease risk stratification obsolete; the invaluable collaboration of cardiologists and OB/GYNs in assessing gender-specific risks; a paper associating increased body mass index in young women with increased risk of subsequent cardiomyopathy; and more.

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Women still underrepresented in clinical research, science and medicine that could save them from their No. 1 killer - Cardiology2.0